Clinical Health Psychology – Feedback

    Clinical Health Psychology

    Feedback Form

    If you need this information in another format, please ask a member of staff. The language can be changed by using the dropdown at the top of this page.

    How helpful have these appointments been to you?

    Equality Monitoring

    The information you enter on this Equality and Diversity monitoring form will be used for monitoring purposes only and will be kept confidential.
    We are required to ensure that the service that is provided is equitably to all communities. We believe that it is good practice to ensure that we analyse patient surveys to find out if different groups have different levels of satisfaction in the services we provide.
    The information you share with us will be used to monitor and evaluate how well we are doing in eliminating discrimination and advancing equality. The NHS is committed to the principles of fairness, consistency, meritocracy and equality of opportunity. The Equality Act 2010 requires equal treatment in access public services, regardless of age, disability, gender re-assignment, marriage or civil partnership, maternity or pregnancy, race, religion or belief, sex and sexual orientation.
    Please complete and tick (✓) the relevant box

    Gender

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    Please select the option which best describes your sexual orientation

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    Disability

    Do you consider yourself to have a disability?

    Please state the type(s) of disability which applies to you. People may experience more than one type of disability, in which case you may indicate more than one.

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